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BINKYBUNNY FORUMS

Forum HOUSE RABBIT Q & A Recurring URI

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    • tanlover14
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        It seems Simba’s URI is back again…. He’s been off the 2nd dose of antibiotics for about three weeks now I believe.  

        Each time this same process has occurred: 

        1.  Grouchy, nippy Simba which is incredibly unlike him. 

        2.  He begins making these odd, congestion sounding noses.

        3.  Thick, milky discharge appears in his nose.

         

        So far we are just waiting for the milky discharge.  I noticed him being a little nippy the other day and tried not to worry.  Then two days ago he began making the odd breathing noises that he was making before (both times when his discharge came back).  Before he’s only made the noises for a few minutes – this time it went on for about a half hour I believe.  It sounded like someone breathing hard with congestion (as in it sounded like snot in his nose or something similar).   I think he may have discharge and we are missing it though because under his nose is beginning to stain the same yellow color the vet noticed last time when he had the discharge. EDIT:  His nose is incredibly wet at all times, almost like he stuck his nose in the water dish even when he didn’t.

        Rather than taking him for CT Scan we have decided to seek a second opinion with one of the (if not the most) respected rabbit vet in the area. He does extensive rescue work with Rabbit Wranglers and other rescues.  And I know his opinion is probably the most trusted in the area.  If I didn’t love my vet so much, I would possibly use him but I’ve heard very bad things about his… um, manner with the furkids parents.  Haha!  (He’s not a people person it seems).  Simba goes for his appointment with this vet tomorrow night.  So we will see what he has to say and his opinion about other options to try also. 

        Does anyone know what a CT scan versus an x-ray shows?  Rabbit Wranglers thought he may suggest an x-ray over a CT scan as it is much cheaper.  What do you all think?  I’m not sure what one might show opposed to the other but I DO know an x-ray is about $2,000 cheaper at his clinic than it would be to travel to Ohio for the CT scan. 

        I am pretty opposed to try another antibiotic though.. I’m incredibly worried about his body becoming resistant to the antibiotics, especially if we are not sure what the underlying cause is for these outbreaks in him. 

         

        Thoughts, opinions, anyone else with experience with chronic URI’s?


      • Irina
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          First, I am sorry to hear about sim a having to go through this! It is terribly stressful when a much loved bunny gets sick.

          Now, I am relatively new to bunnies, but am a people doctor, so I have experience with a lot of what you mention in humans- I don’t know how much of it translates to bunnies.

          1- X-ray vs CT- this is true no matter what species: X-rays are basically pictures of a body part, and are good for showing bony problems, not great for looking at soft tissues like sinuses etc. I really don’t know what information an X-ray would give you. The most you would see is some opacity, or cloudiness in the sinus cavity- but that dies not confirm infection.

          A CT scan gives you much more detail regarding ALL the structures that are being looked at. It is equivalent to taking slices of a body part and looking at it section by section. It gives you information about bone, soft tissues and any organs that are in the area. It can identify abscesses (which are essentially fluid filled sacs that have gotten infected, and often need to be drained to be treated effectively), inflammation, tumors ect. It is definitely a more precise test- but obviously more expensive.

          What is the working diagnosis? Is it a bacterial Infection? Has the vet taken samples if the drainage from his nose for a culture (an attempt to grow any bacteria that are there)? If so, they should be able to test which antibiotics would be effective. If they have not done it, why not?

          My other question would be regarding what the vet is looking for? Does he think there is an abscess in the sinuses causing the problem?
          In humans, we determine the likely problem, and the test just confirms it. Even though an crazy is cheaper- I cannot see what information it would add. I would want to know exactly what he is looking for. I would also ask about the culture of the discharge before committing to such an expensive test, as well as radiation exposure to Simba. They will also likely have to sedate him to get him to sit still for the CT- it takes longer than an X-ray.

          If you have any more information, I would be happy to try and help you navigate through the best way to proceed.

          This is of course related to technical stuff that goes for both bus and people. I do not know about specific bacteria or antibiotics for rabbits.

          Good luck & please post updates!


        • tanlover14
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            Thank you for all the info, Irina! It helps a lot.

            My vet has not done a culture. She gave me legitimate reasoning behind it and I have agreed with it – that’s it’s not necessary. Her reasoning is that rabbits have an incredible amount of bacteria in their noses, good and bad. When you’re taking a sample you could have tens of different types of bacteria in that sample. When you grow a specific bacteria in that sample, there’s no absolute way to determine if that bacteria is the correct bacteria causing the infection (or outbreak). She is very up-to-date on rabbit information, procedures, etc. so I whole-heartedly trust her determination in this. In her opinion, it’s a big debate right now between vets because it’s something that has always been done but there’s no evidence to prove that a culture is detecting the correct bacteria. She said she’s gone to conferences where vets are literally yelling at each other on the floor about whether cultures are effective or note – and she’s very stuck on only following procedures that are PROVEN to be effective with a reason. So I see her stance and I do agree with her unless someone else brings me reasoning to not. She printed out papers from VMI also explaining her reasoning so I feel very good about her taking my concerns with her not doing a culture seriously. We did a full panel blood work AND a blood test for pastuerella. No problems via normal blood work and his pastuerella test came back negative which seemed to surprise everyone. Everyone thought for sure it would be pastuerlla. Or that he at least would have antibodies from being exposed to it.

            With your explanation of x-rays vs. CT scans I think I see the difference in why my vet may suggest that over an x-ray. The x-ray was something someone from the rescue mentioned she thought the new (2nd opinion) vet might do – there’s really no basis that he may suggest this at all beyond that.

            At this point in time, I believe my vet is concerned there could be something wrong with the structure of his nasal passages allowing bacteria to fester up in a pocket somewhere. Basically, now she believes we are too the point where we need to find WHAT exactly is causing the recurrence.

            We are seeking a 2nd opinion also because we worry about having to put him under for the CT scan also. She definitely told us he would have to be put under for a procedure like that… It seems at this point though the prognosis might not be good in regards to the possibility of him needing surgery. It seems a lot of surgeries dealing with this type of thing (I may be getting ahead of myself but my boyfriend and I feel these are all things we need to consider before going for the actual scan) only have a 50% survival rate. At this point – I think we are both confused about where to go from here. If we DO get the CT scan and he needs surgery, I don’t know how much these risks outweigh it being something he can live a long life with if not corrected versus how well he will be able to live with antibiotics for the rest of his life versus taking the risk with the surgery.


          • tanlover14
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              Also, since you added that typically in humans you determine the problem and use the tests to confirm it — in Simba, so far, no one really knows what to think of what is going on. Basically, we’ve been told or under the impression, that anything from here on out is expensive tests that MAY or may not say anything.


            • LittlePuffyTail
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                I’m sorry Simba is still unwell. It’s so frustrating dealing with something and being unable to get any answers. Wishing you both good luck at your appointment and sending lots of (((((( Get Well Vibes)))) for Simba.


              • Irina
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                  I understand about the culture dilemma- however, when looking at samples under the microscope, the bacteria that are the most prominent (as in there are more if them than any others) are likely the ones causing the problem. Given that you are at a crossroads, I would think that it cannot hurt to do a noninvasive test. If a bacteria grows in much higher numbers than the rest, I would try to cover that bug with an appropriate antibiotic. If it works- great. If not- you are no further behind. What do you have to lose?

                  As for the CT- you are right to consider what may arise from those results. If the surgical risk is 50%- what is the risk of no surgery? What is his prognosis if it is not done? I know they do not have a crystal ball, but the more information you have, the easier to make your decision.
                  If you are unlikely to go ahead with surgery, I would usually recommend not getting the CT, as it may be a lot of unwarranted trauma.

                  It is a lot to think about. I wood revisit the culture though. I understand it may not be so useful first line- but we are past that now. Unless there is something to be lost by doing it,
                  Which I cannot see, I don’t understand why it wouldn’t be done.

                  Please keep posting updates!

                  Thinking of you both!


                • Sarita
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                    I agree with Irina, revisit the culture.

                    What type of surgery are you talking about as well?


                  • Jessie1990
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                      I don’t really have any advice, but I hope Simba feels better soon!


                    • tanlover14
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                        The vet we are seeing tomorrow is pretty adamant about cultures I have heard, so unless he disagrees with a culture there will probably be one done. I’m going to bring a list of the meds we have tried, his symptoms, how it progresses and degresses, etc. And see what he thinks and go from there. He is the vet used by our local rescue, Rabbit Wranglers. I’m actually a little nervous to see him since I’ve never heard anything good about his manner towards people. He treated Nora, as well as did her spay and nasal flush. But of course she was still admitted into Rabbit Wranglers at that time so I never went with her to her appointments. They always took her to his clinic he does for their rescues.

                        Nora came home from her spay bopping full of energy like nothing had even happened so maybe he’s a lot better with animals than he is humans

                        Thank you, LPT. I know if anybody understands the frustration it’s definitely you!

                        And thank you for the well wishes, Jessie! I’ll take any healing vibes I can get for my little boy!


                      • Irina
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                          Good luck tomorrow! Please let us know how it goes! More vibes to you and Simba!

                          {{{{{?}}}}}


                        • jerseygirl
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                            I wholeheartedly agree about culture. Nothing to lose! Well, except the cost but that’s nothing compared to a CT right? The time is ideal also as he’s been off antibiotics.

                            I think X-ray would actually be beneficial as it would give dental insight. If you’ve got abscess or root overgrowth (especially in upper arch) this can bring on uri symptoms.
                            He would likely have to be sedated for this but can have a thorough check for spurs on the tooth crowns at the time.
                            That you said he’s been grouchy & nippy immediately made me think of his teeth. That might not be it but it’s something that would need ruling out as it is very common issue in domestic rabbits.

                            (((Simba!))) I hope the vet visit goes well and you come away with some answers.


                          • Irina
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                              JG makes a good point. If dental issues have not been ruled out- an X-ray can definitely aged some light there.


                            • tanlover14
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                                I was REALLY hoping I was wrong and being overly paranoid.. But tonight he just sneezed and we checked him and he had mucous ALL over his face. I had to wipe a bunch off from his face and nose and every time he sneezes a ton of thick, white milky mucous comes out.

                                His teeth had been mentioned before.. but my vet didn’t believe that was an issue since she said typically with root problems and spurs, you notice other stuff on the teeth as well to help indicate those.

                                The 2nd opinion will be good I know… I’m really glad we decided to go and make an appointment as he definitely needs to be seen soon. There’s just so much mucous, it’s the most I’ve seen with him.


                              • jerseygirl
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                                  The nasal discharge is milky but it the stuff that was all over his face clear or milky also?


                                • tanlover14
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                                    Milky. It was literally ALL over him. He just kept wiping his paws all over his nose and face so that probably wasn’t helping. LOL


                                  • jerseygirl
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                                      Ick. Poor Simba!

                                      I thought maybe some was coughed from his mouth if clear. I saw a video one time of a Dutch bunny that had these sneezing/coughing episodes and would get clear gunk all over. Poor thing.


                                    • tanlover14
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                                        So we saw the 2nd vet today – his diagnosis is more along the lines of environmental along with Simba not having enough moisture in his nose. He guesses that the lack of moisture may be causing a build-up in his nose that leads to the random sneezing and white mucous (which can be built up bacteria) in his nose. Once he gets it out, he’s good until the next bout. He told us to try a simple saline solution drops in his nose once daily and see if this begins to help at all. Right now he doesn’t think anything has progressed too far to warrant any further testing. If begins to show any sign of being lethargic, not eating, etc. then he said he would advise an x-ray. He’s also not really on board with giving him another antibiotic so that eases my mind a bit. Although if it happens continually and progresses he said he may do a culture along with the x-ray.

                                        I e-mailed my primary vet with what he said and asked for her opinions/comments on what he had to say. He touched on with the fact that Simba has some (I believe dry eye?) going on, it’s slightly red in the top of his eye and eyelid. Along with he will most likely need trims in the future as he thinks he’s beginning to develop spurs.

                                        Ultimately, I’m not really sure. I’m waiting to hear back from my primary vet. I’m just not sure. By the time we got to the vet, a lot of the mucous was gone. And he had a little bit of the odd breathing noise but not too much. They also gave him a nasal flush but not much came out there either. I should be happy that there’s the possibility it’s something so simple – but the white discharge continues to bother me..


                                      • longhairmike
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                                          usako is on .5ml baytril twice a day and pen-g .5ml twice a week for her chronic upper respiratory infection. for a while it was intermingle at flareups, but since her disorientation rolls began in august, she needs to be on them for the rest of her life now


                                        • jerseygirl
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                                            He touched on with the fact that Simba has some (I believe dry eye?) going on, it’s slightly red in the top of his eye and eyelid

                                            Could the others be grooming his eye too much? Cleaning up some gunk?

                                            Along with he will most likely need trims in the future as he thinks he’s beginning to develop spurs

                                            if it does turn out he has spurs, I highly recommend X-ray to check out his roots.
                                            1st stage of common dental condition is typically elongated roots then followed by spurs forming and uneven molars.
                                            A way you can check to see if something going on dentally is to inspect his incisors for ridges. Vertical ridges are normal. Horizontal ridges can be an early indicator of dental issues.. I so need to check this out on Jersey. She has root overgrowth and spurring already so I’m curious if she also has these ridges.

                                            A dental condition can certainly be a contributor to uri symptoms, along with other factors.

                                            @LHM, I’m not up to date what’s been happening with Usako. Do they know what is causing the rolling? Inner ear infection? Dealing with rolling bunny myself atm and no fun to see. Keep thinking she’ll injure herself.


                                          • LittlePuffyTail
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                                              I hope the new vets suggestions help.

                                              I would take Jerseys advice about the X-ray. Dental roots can press on the nasal area and cause sinus problems. I read this is more common in flatter faced buns.

                                              ((((( Simba))))


                                            • tanlover14
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                                                Thanks for the extra info, Jersey!

                                                I think I forgot to mention that the vet DID look for signs of elongated roots as well as my primary vet. Neither thought this was linked to issues with the teeth but thought that the teeth could be an issue in the future. Neither seemed too worried but said that if he ever stops eating to bring him in to check teeth immediately. Both vets mentioned hoping his continous eating of hay would wear them down further but seemed reluctant to say he wouldn’t ever need trims. He’s always eaten his hay very well so I think teeth trims will most likely be in our future. This vet did suggest X-Rays if teeth problem began to arise though…

                                                I’m pretty adamant about not putting him on any more antibiotics. Unless of course it becomes absolutely necessary. I’m not really sure what kind of saline solution the vet was talking about though – he said a simple saline solution that we would use. I’ll have to call the office later if no one is sure.


                                              • jerseygirl
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                                                  Maybe something from pediatric aisle? Or saline sachets for wound care using an eye dropper would be more economic.


                                                • LBJ10
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                                                    They have sinus rinse, but it would need to be small enough to fit in his tiny nose.


                                                  • Irina
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                                                      You can make your own saline- 1/2 teaspoon salt mixed with 1 cup of water and boil x 15 minutes. You Need a sterile container to store it in.

                                                      For more details, go to:

                                                      http://www.mh.ccac-ont.ca

                                                      Your pharmacist can likely suggest which sinus rinse system would have the smallest catheter.

                                                      Good luck!


                                                    • tanlover14
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                                                        We picked up some simple saline solution – the type you use for contacts. I emailed my vet to make sure it was the correct stuff. It’s supposed to be like a simple nasal flush. The vet said you flush 1 ml of solution up into each nasal passage.

                                                        Here’s a good article from Krempels that sounds VERY similar to what is going on with Simba. It’s interesting. She suggests the same thing and also talks about the causes.

                                                        http://en.allexperts.com/q/Rabbits-703/2011/8/rabbit-recurring-nasal-discharge.htm

                                                        Sarita – the article also touches base on the procedure I was talking about!! I couldn’t find the exact name for the past day and when I read this article today I was ecstatic to find the surgery I was talking about in the earlier post!

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                                                    Forum HOUSE RABBIT Q & A Recurring URI